DR. NEHA ARORA

Dr.Gayatri S

Abstract

An 18-year-old male presented with a history of photophobia for 2 years. He was diagnosed with Acrodermatitis Enteropathica (AE) at 3 years of age and was on regular zinc and riboflavin supplements. He developed scaly, erythematous plaques over his hands, feet and groin over the last 2 years. He had photophobia and watering of eyes, worse in the mornings. On ocular examination, BCVA was 6/9; N6 OU, he had bilateral symmetrical sub epithelial opacities adjacent to the superior limbus, extending to the visual axis, with a small epithelial erosion in the left eye. Fluorescein staining demonstrated a whirling pattern suggestive of partial limbal stem cell deficiency (LSCD). He was treated with multivitamin supplementation, topical lubricants and topical Vitamin A ointment. Subepithelial corneal opacities in a radial pattern mimicking drug toxicity in AE has been reported before, but this is the first case which has been identified as LSCD with its classical features.